Paperless Hospitals

Authors

Melanie HoodMike Kramer

Alyssa GraysonSarah Smith

Objectives

• Define and describe trend• List and describe trend hardware and software• Identify, describe and review trend information and system• Describe advantages/disadvantages of using trend• Examine legal and ethical issues related to the use of trend• Describe technology - related competencies needed by the

professional nurse working with trend• Describe functions of the informatic nurse working with trend

What is a paperless hospital?

• A computer-based record containing health care information. • This system will increase patient care and safety. • It is the potential of electronic medical records to provide large-scale

improvements in the efficiency, safety, and cost-effectiveness of health care

•  They will eliminate or substantially reduce medication related errors in the facility

•  This system will eliminate problems with legibility, ambiguous abriviations, and delays in order communication. 

•  It will clinically benefit by automatically verifying orders by checking dose, drug to drug interations, and allergies. 

  (Russ, 2010)

HARDWARE

Available Hardware

• Wireless tablet PC's• Scanners• Printers• Stylus • Touch Screens• Keyboards

Farcus, 2009. page 17.

Wireless PC

A wireless PC is a computer that has the ability to become wireless and carried from patient room to room.

(Ellison, & Evans, 2003)

Wireless PCs will have WiFi capability.

The PCs that the hospitals would be equipped with would have software with the ability to turn these hospitals

paperless.

Available Software

• Billing• Electronic prescriptions• Physician's orders• Nurse’s notes• Laboratory results • H&P• Advanced directives• Nutrition • Non- physician orders• Etc.

Electronic Prescriptions

Increase patient safety and reduce pharmacy callbacks.

• Quick prescription refill processing• Increases prescription accuracy• Color-coded patient drug history maintains current,

expired, ineffective, discontinued, and sample prescriptions.

(Allscripts electronic prescribing, 2009)

Clinical Information System: Accustat EMR: •  Order entry system• Manages transcription cycle & reduces errors & costs• 24/7 Access to transcription

 • Dictate, prioritize, and tracks jobs in real time

 • Automatic attachment to patient EMR

(www.acustatemr.net) 

Who Uses and benefits from AccustatEMR?     Primarily used by Physicians   Benefits:• Nurses• Patients • Medical secretaries 

AccustatEMR enables the physician to:

• Provide online billing• Document test results and lab findings• Document physician's progress notes and orders• Prescribe new medications for patients

More About Accustat EMR...

• Configuration: Point of Service system

• Regularly exceeds the American Healthcare Association Integrity Standards (AHIMA)

• Routine audits by HIPAA compliance team

Reasons we recommend Accustat EMR:

• Personalized to individual facility needs

• Physician and patient convenience

• Cost effectiveness• Reduction in serious medical

& prescription errors• Easy access to edit, search,

and view medical transcriptions

• Personalized care• More accurate patient

billing• Less med errors

• Legible physician orders• Emailing of charts• No way of wrong patient

charting

(Lamburg, 2008)

Disadvantages

• Cost• Educating Staff• Complete Cooperation• Time Management

(Lamburg, 2008)

Ethical/Legal Issues

• Paper-era state regulations that may not permit EHRs o state regulation of medical records is based upon the rules of paper records

(Shay, 2005)

• HIPAA’s privacy and security regulationso unrelated physicians of record sharing organizations can locate, request

and obtain the medical records of patients

Ethical/Legal Issues

• Anti-trust Lawso  The laws prohibit anti-competitive behavior, including price fixingo Sharing payment information could enable competing providers to collude on

prices and violate the anti-trust laws. (Shay, 2005)

•  Creating a Legal Document o EMRs must be stored legally, if not they may be deemed invaildo if they do not meet legal requirements, the payor can sometimes deny

the claim

Competencies required to work in Paperless Hospitals:

• Ability to:o Access and use emailso Search databases and obtain informationo Navigate institution specific software regarding

charting and administering medso Operate Windows applications

(McGonigle, 2009) 

Functions and Responsibilities of the INS:

• Possess the knowledge and skills specific to paperless hospital software, hardware, and the clinical information system used by their facility

• Use critical thinking and computer skills to assist with hospital technology

• Teach and assist others with learning new information and technology

• Assist with implementation and evaluation of the Clinical Information System

(McGonigle, 2009)

In conclusion:

1.A paperless hospital will require new hardware/software

2.There are many different software to choose from3.A customized software is needed for each area of

healthcare4.This system will require all staff to transition to a

different way of thinking5.The advantages out weigh the disadvantages6.A paperless hospital will change the way of

nursing 

References

Cucina, Russ. "Information Technology in Patient Care" (Chapter). McPhee SJ, Papadakis MA, Tierney LM, Jr.: CURRENT Medical Diagnosis & Treatment 2010: http://www.accessmedicine.com/content.aspx?aID=779189.

Allscripts ( 2009, July). Electronic prescribing - TouchChart eRx. Retrieved [date] from MDS Medical website: http://www.mdsmedicalsoftware.com/allscripts/electronic-prescriptions.php

Ellison, C., & Evans, D. (2003, October 14). Wireless networks. Retrieved from http://www.pcmag.com/article2/0,2817,1275533,00.asp Farcus, N. (2009). Introduction to computer hardware lecture. Nurs 457.

References:(2009). Accustat EMR. In Digital Medical ASP Transcription.                                    Retrieved December 1, 2009, from             http://accustatemr.net/default.aspx.McGonigle, D. & Mastrian, K. ( 2009). Nursing informatics and the            foundation of knowledge. Boston: Jones & Bartlett Publishers. Lamburg, S.I. (2008, May 24). Paperless or less paper. Retrieved from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75K6-4SK9CWR-J&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1121678625&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=795bc94818ea40d062fff6926535a25cShay, Edward F., and Esq..(2005). "Legal barriers to electronic health records." Physicans News. N.p., n.d. Web. 4 Dec. 2009. <http://www.physiciansnews/law/505.html>. "Legal Issues of the ELectronic Medical Record." Medical Practice Management Trends. N.p., n.d. Web. 4 Dec. 2009. <http://www.medicalpracticetrends.com/2009/07/19/emr-legal-issues/>.